Impact of pulmonary rehabilitation on psychosocial morbidity in patients with severe COPD
Abstract
Study objective To assess the effect of pulmonary rehabilitation (PR) on psychosocial morbidity, functional exercise capacity, and health-related quality of life (HRQL) in patients with severe COPD.Design A prospective, randomized, controlled trial with blinding of outcome assessment and data analysis.Setting A tertiary-care respiratory service.Patients Forty patients (mean age, 65 +/- 8 years [+/- SD]) with severe chronic flow limitation (FEV(1), 35 +/- 13%) without respiratory failure (Pao(2), 72 +/- 9 mm Hg; Paco(2), 42 +/- 5 mm Hg) were randomized either to a control group or to a PR group (PRG).Interventions Sixteen weeks of PR that included breathing retraining and exercise.Measurements At baseline and 16 weeks, we evaluated psychosocial morbidity using two questionnaires (the Millon Behavior Health Inventory [MBHI] and the Revised Symptom Checklist [SCL-90-R]) and measured 6-min walk distance (6WMD) and HRQL using the Chronic Respiratory Questionnaire (CRQ).Results We found differences in favor of the PRG in the following MBHI domains: introversive, forceful, and sensitive personality styles (all p </= 0.05) and chronic tension (p </= 0.01). Results of the depression, hostility, global severity, positive symptom distress index (all p </= 0.01), somatization, anxiety, psychoticism, and positive symptom (all p </= 0.05) domains of the SCL-90-R favored the PRG. We also found statistically and clinically significant differences between groups in 6MWD (85 m; p < 0.01) and in two domains of the CRQ: dyspnea (1.0; p < 0.01) and mastery (0.6; p < 0.05). The other two domains of CRQ showed strong trends in favor of PRG: 0.7 for both fatigue and emotional function (minimal important difference, 0.5).Conclusions PR may decrease psychosocial morbidity in COPD patients even when no specific psychological intervention is performed. Findings from this study also confirm the positive impact of PR on functional exercise capacity and HRQL.
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Exercise-based PR programs have been among the most consistently helpful interventions for minor mood symptoms in COPD.
“Exercise-based PR programs have been among the most consistently helpful interventions for minor mood symptoms in COPD.98,100–102”
From Anxiety and Depression in COPD (2008) · cites this paper as [98]
Participation in supervised whole-body exercise training has been shown in several randomized controlled trials to improve symptoms of anxiety and depression as a consequence of training-related gains in functional capacity.
“Subsequent participation in supervised whole-body exercise training has been shown in several randomized controlled trials95–98 to improve symptoms of anxiety and depression as a consequence of training-related gains in functional capacity.”
From Anxiety and Depression in COPD (2008) · cites this paper as [98]
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References 31 · Cited by 138
- Authors
- Güell, R., Resqueti, V., Sangenis, M., Morante, F., Martorell, B., Casan, P., & Guyatt, G. H.
- Affiliations
- Universitat Autònoma de Barcelona (ES)
- McMaster University (CA)
- Corresponding author
- Güell, Rosa
- Venue
- Chest
- Publisher
- Elsevier BV
- Published
- 2006-04
- Volume
- 129
- Issue
- 4
- Pages
- 899-904
- ISSN
- 0012-3692 (ISSN-L)
- OpenAlex
- W2123221145
- Cited by
- 138
- References
- 31
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 5 · 2020: 1 · 2019: 4 · 2018: 8 · 2017: 3 · 2016: 6 · 2015: 6 · 2014: 10 · 2013: 10 · 2012: 10
- FWCI
- 10.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- CHEST Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
- Keywords
- pulmonary rehabilitation, chronic obstructive pulmonary disease, psychosocial morbidity, health-related quality of life, exercise capacity, breathing retraining, depression, anxiety, personality traits, dyspnea, mastery
- MeSH terms
- Aged, Breathing Exercises, Female, Health Status, Humans, Male, Middle Aged, Prospective Studies, Psychological Tests, Quality of Life, Severity of Illness Index, Exercise, Exercise Tolerance, Pulmonary Disease, Chronic Obstructive
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